Key takeaways

  • Onyda XR is an FDA-approved, orange-flavored liquid for children ages 6 years and older. It’s given at bedtime and is ideal for those who find swallowing pills difficult.
  • Onyda XR can significantly reduce ADHD symptoms. It works effectively alone or in combination with a stimulant medication.
  • Children taking Onyda XR require regular heart rate and blood pressure monitoring by a doctor. Never stop the medication without a doctor’s guidance.

Finding the right medication for a child with Attention Deficit Hyperactivity Disorder (ADHD) can be a journey or trial and error.

Onyda XR is a brand-name liquid medication given at bedtime that can improve symptoms of ADHD in children.

This article explains what it is, how it works, and what you need to know before starting treatment. It also outlines the potential side effects and offers practical tips for parents.

Onyda XR is a Food and Drug Administration (FDA)-approved prescription medication used to treat ADHD. It contains the active ingredient clonidine hydrochloride.

Unlike many traditional ADHD medications that come in pill form, Onyda XR is an orange-flavored extended-release (XR) oral suspension (a liquid). It has a strength of 0.1 milligram (mg) of clonidine hydrochloride per milliliter (mL).

The liquid form makes it an option for children who have trouble swallowing pills.

Onyda XR is approved for children ages 6 years and older. Children may take it alone as the only treatment for ADHD, or use it alongside other central nervous system (CNS) stimulant medications.

It is not known if Onyda XR is safe or effective for children under age 6.

Onyda XR is not a stimulant. It belongs to a class of medications called centrally acting alpha2-adrenergic agonists.

It works by stimulating specific receptors in the brain stem to help decrease hyperactivity and impulsivity.

Clinical trials show that Onyda XR is highly effective at reducing ADHD symptoms, such as hyperactivity and impulsivity.

In a 5-week study, children taking Onyda XR saw their ADHD symptom scores drop by 8.5 to 9.1 points, which was significantly more than those taking a placebo.

In another long term study, the “treatment failure” rate was much lower for those on Onyda XR (45.6%) compared to those on a placebo (62.7%).

When used alongside a standard stimulant medication, Onyda XR improved symptoms more effectively than using the stimulant alone.

The starting dose for Onyda XR is usually 0.1 mg, taken by mouth once daily at bedtime. A child can take it with or without food.

If needed, the doctor might increase the amount slowly by 0.1 mg each week, up to a maximum recommended dose of 0.4 mg per day.

What to do about a missed dose

If a dose is missed, skip it and give the next scheduled dose at the normal time. Never double up to make up for a missed day.

How do you give Onyda XR to children?

You give Onyda XR by mouth once daily at bedtime, with or without food. Here are some dosing tips:

  • Discard older medication: For the 30 mL and 60mL bottles of Onyda XL, throw away any unused medication 30 days after opening the bottle. For the 120 mL bottle, discard any unused contents after 60 days.
  • Shake well: Gently shake the bottle for at least 10 seconds before every dose to mix it evenly and avoid foaming.
  • Use the right measurement tool: Always use the oral dosing syringe and bottle adapter provided in the carton to measure the exact dose in milliliters.
  • Do not switch directly: If your child is switching from another clonidine product (like a pill or patch), you cannot substitute them milligram-for-milligram because they are absorbed differently by the body.

Why is Onyda XR given at bedtime?

A common side effect of Onyda XR is sleepiness and sedation. Giving the dose at night allows a child to sleep through the most intense drowsy effects, which helps manage their ADHD symptoms during the day without making them overly lethargic.

Like all medications, Onyda XR can cause a range of side effects.

Most common side effects

The most common side effects of Onyda XR include:

  • sleepiness, tiredness, and fatigue
  • irritability
  • nightmares and trouble sleeping
  • constipation
  • dry mouth
  • decreased appetite and dizziness (especially when used with a stimulant)

Serious side effects

The most serious side effects include:

  • decreased blood pressure and a lowered heart rate, which can lead to fainting
  • high blood pressure if the medication is stopped suddenly
  • severe allergic reactions, such as skin rash, hives, or swelling of the face, lips, or tongue
  • problems with the heart’s electrical system

Experiencing side effects? After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking this drug and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

You should call 911 or call your local emergency number if a child experiences the following symptoms:

  • hives
  • swelling of the face or throat
  • difficulty breathing
  • skin turning blue or gray
  • fainting
  • slow heart rate

Regular monitoring is necessary while a child is on Onyda XR. A doctor will need to check the child’s heart rate and blood pressure before starting the medication, after any dose increases, and regularly throughout their treatment.

Yes. Onyda XR can interact with several other drugs.

It should not be taken with alcohol or central nervous system depressants, like certain anti-anxiety medications or sleep aids, as these can increase sleepiness and sedation.

Taking blood pressure medications, tricyclic antidepressants, or drugs that affect the heart rhythm, like beta-blockers, may cause dangerous drops in blood pressure or heart rate issues.

It is important to ensure a child does not become overheated or dehydrated, as this increases the risk of fainting from low blood pressure.

The following tips may help ensure safe and effective use of Onyda XR:

  • Use medication reminder apps to remember to give Onyda XR at bedtime.
  • Record times and doses in a medication log to ensure consistency.
  • Record the date you first open the bottle to ensure you know when it must be discarded if unused (30 days or 60 days).
  • Discuss the child’s medication with their school staff and ask them for feedback about the child’s mood and behavior at school.
  • Ensure the child drinks plenty of water or other hydrating drinks to help prevent constipation.
  • Store OnydaXR at room temperature between 68°F to 77°F (20°C to 25°C).
  • Store it out of direct sunlight and keep it in the original bottle.
  • Close the child-resistant cap tightly.

Do not stop giving a child Onyda XR suddenly, as it can cause a dangerous spike in blood pressure (rebound hypertension) and withdrawal symptoms like headache, nausea, rapid heart rate, and anxiety.

To stop safely, a doctor will guide you to slowly taper the total daily dose down by no more than 0.1 mg every 3 to 7 days.

Because Onyda XR is a newer brand-name medication without a generic version, its retail price can be high.

The price you pay will depend on your insurance coverage. Your insurance company may require prior authorization before it agrees to cover it.

To help lower costs, Onyda XR’s manufacturer offers the Tris savings card to eligible individuals with commercial insurance. This allows you to pay as little as $25 per prescription.

If you don’t have insurance, you can still look into cash-paying assistance, pharmacy discounts, or patient assistance programs that might provide the medication for free if your income is within a certain range.

Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.

Children must be at least 6 years old to start taking Onyda XR.

After taking a dose of Onyda XR, peak drug levels in the body happen around 7.5 hours later. In clinical trials, children showed a significant reduction in symptoms after 5 weeks of use.

Yes. Onyda XR is FDA approved to be used as an adjunctive (add-on) therapy alongside central nervous system stimulant medications to help better control ADHD symptoms.

Onyda XR contains the active ingredient clonidine, but it is a very specific form of it. Onyda XR is used differently in the body than other clonidine medications, such as immediate-release pills or skin patches. For this reason, you can’t simply switch one medication for the other.

Always follow a doctor’s instructions for switching between medications.

If a child vomits, they might not absorb their dose of Onyda XR. Do not give them another dose. Give them their next dose at their scheduled time.

Onyda XR is a once-daily liquid ADHD treatment that can help manage symptoms in children ages 6 years and older.

Because it can lower blood pressure and cause sleepiness, you must give it at bedtime. A doctor should monitor a child’s health regularly.

If a child experiences side effects that don’t go away, talk with their doctor. Always seek a doctor’s advice about stopping Onyda XR, as stopping abruptly can be dangerous.

Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.